While some suggest that radiation has a role only in adjuvant treatment of patients with positive margins, these data show that a benefit exists with adjuvant concurrent chemoradiation, regardless of margin status. This is limited, however, by the lack of inclusion of patients treated with adjuvant chemotherapy alone in this study.

The median survival of patients treated with chemoradiation in this study was 21.1 months, which compares favorably with the highly selected patients of the CONKO-1 trial (low post-operative CA 19-9 levels), where there was a median survival of 22.8 months in the gemcitabine arm and 20.2 months in the observation arm.